Effects of mobilization and tactile stimulation on recovery of the hemiplegic upper limb: a series of replicated single-system studies.
OBJECTIVE
To explore the effects on motor function and impairment of mobilization and tactile stimulation for the paretic arm and hand after stroke.


METHODS
Replicated single-system series, ABA design.


METHODS
The stroke rehabilitation ward of a community hospital in the United Kingdom.


METHODS
Consecutive sample, men and women (N=6) with stroke (left or right), within 3 months of onset.


METHODS
Sixty minutes of daily mobilization and tactile stimulation to the paretic arm and hand for 6 weeks in addition to the usual rehabilitation program.


METHODS
Focal disability (Action Research Arm Test [ARAT]) and motor impairment (Motricity Index arm section).


RESULTS
All participants showed visual change in 1 or more of trend, level, or slope between baseline and intervention phases for both the ARAT and the Motricity Index. The visual analysis was confirmed through statistical testing (c statistic and/or Mann-Whitney U test) for 5 of 6 participants (statistical analysis was precluded for 1 participant). No further improvements were made on intervention withdrawal.


CONCLUSIONS
This study shows proof of concept for using mobilization and tactile stimulation to improve motor recovery after severe paresis, justifying conducting dose-finding studies as a precursor to multicenter phase III clinical trials.
Hunter
Susan M
SM
Research Institute for Life Course Studies, Keele University, Keele, UK. s.m.hunter@shar.keele.ac.uk
Crome
Peter
P
Sim
Julius
J
Pomeroy
Valerie M
VM
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D014110:Touch / Q000502:physiology*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*